The candidate is submitting a proposal for a K23 Award from the NICHD with a short-term career development goal of enhancing her research skills and a long-term goal of developing a program of research that includes clinical trials designed to evaluate the efficacy of psychosocial interventions for children with chronic illness and their families. To meet these goals, she proposes a career development plan that includes participation in the Clinical Investigator Preparatory Program (CIPP) offered through the University of Wisconsin Medical School. The proposed research project will evaluate the impact of newborn screening and diagnosis on the parent-infant relationship; examine the interactional mechanism that may contribute to a parent-infant relational disturbance; and identify parent, infant, and parent-infant dyadic variables that may serve as mediating factors in the quality of the parent-infant relationship. Four groups will be compared: a) families with infants who have CF diagnosed through newborn screening (CF-D), b) families with infants who are heterozygote CF mutation carriers identified through newborn screening (CF-C), c), families with infants who have congenital hypothyroidism (CH) diagnosed through newborn screening (CH), and d) families who have healthy infants (H) with normal screening results. The design will consist of multi-modal methods including empirically validated self- report measures, observational measures, and chart review. Data will be collected on parent, infant, and parent-infant interactional variables. Independent variables will consist of parents' level of task-oriented behaviors and emotional responsiveness in interactions with their infants as measured by an observational method. The primary dependent variable will be the quality of the parent-infant attachment relationship as measured by parental self-report and an observational method. Mediating factors will include parental psychological symptoms, stress, and coping style, as well as infant temperament, developmental status, and illness severity. Families will be followed and data collected over one year to document parent-child relationship changes over the infant's first year. Demographic variables will be controlled statistically. This study will provide important data for development of an intervention study for this genetically at risk population.